I-anal / perianal fistula: yintoni, iimpawu kunye nokuba utyandwa nini

Umxholo

• Iimpawu eziphambili
• Unyango lwenziwa njani
• Unjani uchacha
• Uya nini kwagqirha

I-anal fistula, okanye i-perianal, luhlobo lwesifo, esivela kwinxalenye yokugqibela yamathumbu ukuya kulusu lwe-anus, ukudala itonela elimxinwa elibangela iimpawu ezinjengeentlungu, ubomvu kunye nokopha kwi-anus.

Ngokwesiqhelo, i-fistula ivela emva kwethumba kwi-anus, nangona kunjalo, inokubangelwa zizifo zamathumbu ezivuthayo, ezinjengesifo sikaCrohn okanye i-diverticulitis, umzekelo.

Unyango phantse luhlala lusenziwa ngotyando, ngoko ke nanini na xa kukrokreleka i-fistula, ngakumbi ukuba ubenalo ithumba, kuyacetyiswa ukuba uqhagamshelane nogqirha ukuze aqinisekise isifo kwaye uqale unyango.

Jonga ukuba zeziphi ezinye izizathu ezibangela iintlungu kwi-anus okanye ukurhawuzelela kuloo mmandla.

Iimpawu eziphambili

Ezona mpawu ziphambili ze-anal fistula zibandakanya:

• Ubomvu okanye ukudumba kolusu lwe-anus;
• Intlungu engapheliyo, ngakumbi xa uhleli okanye uhamba;
• Ukuphuma kobofu okanye igazi nge-anus;

Ukongeza kwezi mpawu, iintlungu zesisu, urhudo, ukuphelelwa ngumdla wokutya, ukwehla kobunzima bomzimba kunye nesicaphucaphu sinokubakho xa usulelo okanye ukudumba kwefistula kusenzeka.

Kwezi meko, kuyacetyiswa ukuba udibane nengcali yokuchonga ingxaki ukufumanisa ingxaki, ngokujonga isiza okanye ukubonwa kwemagneti, umzekelo, kunye nokuqala unyango olufanelekileyo.

Unyango lwenziwa njani

Ukunyanga i-anal fistula, kwaye uthintele iingxaki ezinje ngokusuleleka okanye ukungasebenzi kakuhle kwendle, kufuneka wenze utyando, olubizwa ngokuba yi-anal fistulectomy, apho ugqirha:

1. Yenza ukusika kwi-fistula ukuveza itonela yonke phakathi kwamathumbu nolusu;
2. Isusa izicwili ezonzakeleyo ngaphakathi kwifistula;
3. Beka ucingo olukhethekileyo ngaphakathi kwististula ukukhuthaza ukuphiliswa kwayo;
4. Inika amanqaku kuloo ndawo ukuvala inxeba.

Ukuthintela iintlungu, utyando luqhele ukwenziwa nge-anesthesia ngokubanzi okanye kwi-epidural anesthesia kwaye, ngaphambi kokuqala inkqubo, ugqirha usebenzisa iphenyo ukuphonononga i-fistula kunye nokuvavanya ukuba kukho itonela elinye kuphela okanye ngaba yifistula entsonkothileyo, apho kukho amatonela. Kule meko, kunokuba yimfuneko ukwenza utyando olungaphezulu kwesinye ukuvala itonela elinye ngexesha.

Ukongeza kwi-anal fistulectomy, zikhona ezinye iindlela zokunyanga i-fistula ngotyando, njenge-graf, iiplagi kunye ne-sutures ezikhethekileyo, ezibizwa ngokuba yi-setons, kodwa ezi ndlela zixhomekeke kuhlobo lwe-fistula kunye nesifo esisibangeleyo, njengesifo sika-Crohn Kuyimfuneko ukusebenzisa amayeza, anjenge-Infliximab ngaphambi kotyando.

Unjani uchacha

Emva kotyando, kuhlala kufanelekile ukuba uhlale esibhedlele okungenani iiyure ezingama-24 ukuqinisekisa ukuba ifuthe le-anesthesia liphelile kwaye akukho ngxaki, njengokuphuma kwegazi okanye usulelo.

Emva koko kunokwenzeka ukubuyela ekhaya, kodwa kuyacetyiswa ukuba uphumle iintsuku ezi-2 ukuya kwezi-3, ngaphambi kokuba ubuyele emsebenzini. Ngeli xesha, kunokuba yimfuneko ukuthatha amayeza okubulala iintsholongwane, afana ne-Amoxicillin kunye ne-Clavulonate, okanye amachiza ahlasela ukudumba, afana ne-Ibuprofen, emiselwe ngugqirha, ukunciphisa iintlungu kunye nokuqinisekisa ukuba usulelo aluveli. Ukunciphisa umngcipheko wosulelo, ucoceko lommandla kufuneka ugcinwe ngamanzi kunye nesepha ye-pH engathathi hlangothi, ukongeza kutshintsho lokunxiba, ukuthambisa amafutha okuthambisa iintlungu ubuncinci amaxesha ama-6 ngemini.

Ngexesha lasemva kokuhlinzwa kuqhelekile ukuba inxeba lokopha kancinci, ngakumbi xa usula iphepha langasese kuloo mmandla, nangona kunjalo, ukuba ukopha kunzima okanye ukuba kukho naluphi na uhlobo lweentlungu ezibi, kubalulekile ukubuyela kugqirha.

Ukongeza, kwiveki yokuqala kubalulekile ukulandela ukutya ukuze uphephe ukuqhina, kuba ukuqokelelwa kwelindle kunokonyusa uxinzelelo ezindongeni zendlela kwaye kuthintele ukuphilisa. Jonga indlela yokwenza olu hlobo lokondla.

Uya nini kwagqirha

Kuyacetyiswa ukuba uqhagamshelane nengcali ngokukhawuleza xa kubonakala:

• Ukopha kwi-anus;
• Ukwanda kwentlungu, ukuba bomvu okanye ukudumba;
• Umkhuhlane ongaphezu kwama-38ºC;
• Kunzima ukuchama.

Ukongeza, kubalulekile ukuba uye kugqirha kwimeko yokuqhinwa enganyamalali emva kweentsuku ezi-3, nokuba usebenzisa laxatives.